Media captionHow mobile phones are being used to combat the trade in fake medicines

The steel door of the shipping container in Nigeria's Lagos port swings open to reveal hundreds of cardboard boxes packed with sachets of anti-malaria medicine.

But these pills would be of no use to someone suffering from the life-threatening condition.

The packaging may be identical to an Indian-manufactured drug which sells well in Nigeria, but when the pills were examined in a laboratory they were found to contain nothing more than chalk.

These fake drugs were produced in China and were seized by Nigeria's National Agency for Food and Drug Administration and Control (Nafdac).

The war against counterfeit medicine has been on for more than 20 years in Nigeria.

It is impossible for anybody to know, even for the manufacturers themselves - unless you go to the labNnamdi Okafor, May and Baker Nigeria PLC

"With the crackdown on illegal narcotics, drug barons have redirected their resources to manufacturing counterfeit medical products because it is more lucrative and less risky," says Dr Paul Orhii, the director general of Nafdac.

Comprehensive surveys have not been carried out for some years, but a report by the World Health Organization in 2011 suggested the war is far from won.

It said more than two-thirds of malaria medicine in Nigeria was fake or substandard.

Now the consumers of the medicine are being armed with exactly what they need to outwit the counterfeiters.

More and more packs of medicine produced by pharmaceutical companies have a small strip added to the packaging - similar to the scratch panel people are used to seeing on a mobile phone charge-card.

"When the patient picks the medicine off the shelf they scratch the panel to reveal a unique number or code," says the Ghanaian entrepreneur Bright Simons.

"The consumer takes out a mobile phone and sends the code to a toll-free number," he explains.

Standing in a market in Lagos, the founder of the organisation mPedigree tests out the technology.

Within two seconds of texting the number from a pack of anti-malaria medicine, a message appears on his phone with the word "YES" - a simple response meaning the drug is genuine.

"This allows even illiterate people to latch on," says Mr Simons.

"If they receive the word 'NO' there will also be a local number so they can alert the authorities about this encounter with a potentially toxic or fatal chemical masquerading as medicine."

Valuable data

Can you spot the counterfeit?

Image caption
The top picture shows the genuine medicine packet on the left and the bottom has the fake pill on the left

Top photo: Genuine anti-malarial medicine packet on the left; fake on the right

Bottom photo: Fake pill on the left; genuine tablet on the right

MPedigree is now operating in eight countries including Ghana, Kenya, Nigeria and India. Cameroon and Rwanda are next.

For the service to work, the national drug regulators, mobile phone networks and pharmaceutical companies have to come on board.

For them the technology has the potential to provide valuable data about the demand for their medicine in order to plan their distribution more efficiently and precisely.

Most of the packets of medicine with the scratch panel are currently available in hospitals to allow doctors and nurses to be sure of what they are giving patients.

But by the end of February mPedigree hopes there will be 10 million packets in pharmacies across the world.

In a $30m (£18.6m) state-of-the-art pharmaceutical factory just outside Lagos, laboratory technicians keep a close eye on digital readouts as huge steel containers mix up the ingredients for an antibiotic pill.

With Nigeria's population of about 170 million and its ambitions to become a major exporter, this is potentially an extremely lucrative business for the company May and Baker which has operated in Nigeria for 70 years.

Profits are dented by a lack of electricity, making huge diesel-thirsty generators a necessity.

The business is also threatened by the counterfeiters, so mPedigree is a welcome partner.

"I can estimate that over 20% of our top line is lost to the activities of these guys," says Nnamdi Okafor, the managing director May and Baker Nigeria PLC.

"They are very smart people. Usually they wait for you to come up with a new product," says Mr Okafor, standing next to machines which spit out two million antibiotic pills a day.

"And the moment they see that the product has got some good equity in the market, they move quickly.

"They copy everything from the physical product to the packaging and the logo," he says.

"Everything will be exact and sometimes they even come out looking better than the original product.

"It is impossible for anybody to know even for the manufacturers themselves - unless you go to the lab."

Enemies

Of course the key difference is the content of the medicine.

Image copyrightAFP

The bullet went through my headscarf and passed through the windscreen of the car, leaving my hair burntDora Akunyili, Former head of Nafdac

Sometimes the fake drugs include 20% of the active ingredient - enough to produce a characteristic taste or smell.

Patients have also been duped into swallowing capsules full of sawdust as well as pills of chalk.

For one woman, the war on fake medicine became a personal fight.

"My younger sister, Vivian, our last born, was one of the nicest human beings that ever lived," recalls Dora Akunyili, the former head of Nafdac.

"She became diabetic and was taking insulin.

"We noticed she would not react to the insulin from some shops and the blood sugar kept going up," she said.

"It didn't sink in that this was fake medicine."

Vivian died in her mid-20s.

After taking up the leadership of Nafdac in 2001, Ms Akunyili made plenty of enemies as she tried to smash the lucrative fake drug industry.

"My car was shot from behind on 26 December 2003," she said.

"The bullet went through my headscarf and passed through the windscreen of the car, leaving my hair burnt."

Despite threats against her family and violent attacks on her colleagues, she did not give up, heading the agency for seven years.

"When the drug counterfeiters heard I might be quitting the job they started popping champagne in Onitsha market, rejoicing that this wicked woman would soon quit the scene," she told the BBC.

"But I felt if I left the job that would be victory for the drug counterfeiters," she said.

Every Nigerian who walks into a pharmacy store with a cellphone in hand is a potential Nafdac informerDr Paul Orhii, Nafdac director general

'Running them out of town'

Whilst welcoming the mPedigree technology, she has concerns that high illiteracy rates could undermine the initiative and believes the best way to end the deadly crime is to stop the importation of the fake drugs from China and India.

The authorities in Nigeria had ordered that by 2 January 2013 all anti-malaria medicine should include the mobile phone verification scratch panels.

The deadline was not met but the current Nafdac director general believes with the new initiative, the war will be won.

"We are putting the power of detection of counterfeit medicine into the hands of the Nigerian consumer," says Dr Orhii.

"With 80 million Nigerians using cellphones, it is like we have 80 million staff in Nafdac.

"Every Nigerian who walks into a pharmacy store with a cellphone in hand is a potential Nafdac informer."

Rolling out the technology is slow but the founder of mPedigree knows that the invention has the potential to finish the fake drug manufacturers.

"We are collating data to allow the law enforcement authorities to track them because we know exactly where these problems occur," Mr Simons says.

"We are putting pressure on them from every angle. We are not only squeezing them we are running them out of town," he says, with his weapon, the mobile phone, in hand.